Individual
HOWARD A THALACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1222 E WOODLAND AVE, BARRON, WI 54812-1765
(715) 838-5222
Mailing address
1222 E WOODLAND AVE, BARRON, WI 54812-1765
(715) 838-5222
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18516
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30975400
—
WI
Enumeration date
05/01/2006
Last updated
07/15/2009
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